Doctors at two private healthcare facilities have observed a spike in cases of tuberculosis (TB) among people recovered from COVID-19. They have accounted diabetes, altered immunity and use of steroids to be responsible for the increase.

Moolchand Hospital has seen about 10 cases of active TB patients in the OPD over the last four to six weeks. Dr Bhagwan Mantri, a pulmonologist at Moolchand Hospital, said that up to 60% of them are below the age of 40 years. He added that all these TB patients received steroids during their COVID treatment and many of them had diabetes. 

He stated that the patients presented with cough several weeks after recovery from COVID-19 and some also had mild low-grade evening fever for three to four weeks after Covid. X-ray and sputum test revealed cavitary pneumonia with sputum positive smear for Acid-Fast Bacillus (AFB). 

Dr Mantri said that a young man presented with massive pyo-pneumothorax after COVID which was eventually found to be due to TB.

He mentioned that the cause for the increased odds of TB in post-COVID patients can be explained by factors such as altered immunity, lung inflammation and stress due to COVID, steroid use for COVID treatment and inadequate blood sugar control.

He stated that the patients should monitor certain markers after recovering from COVID for early diagnosis of TB. He further stated that a delay in diagnosis of TB has been reported as the symptoms of TB are similar to those of post COVID/Long COVID. Dr Mantri said that if someone is having any persistent symptoms after COVID-19 infection, such as low-grade fever, cough, decreased appetite, weight loss, night sweats or any other complaints, they must visit a pulmonologist to rule out active TB.

Aakash Healthcare, Dwarka has also witnessed a 15-20% rise in cases of TB, in comparison with previous years. There has also been an increase in recurrent TB cases.

The reasons could range from ignoring the health and labeling the fever or other symptoms to be due to some other viral illness, to anxiety about going to hospital due to the fear of contracting COVID infection.

Many patients had a history of COVID and attributed their poor health to its after effects. Cases of misdiagnosis can also add to the burden of TB during the COVID-19 pandemic. A thorough evaluation is needed for any fever that lasts more than two weeks, or weight loss or poor appetite or prolonged cough/diarrhea. Any change in health status must be evaluated by a qualified health professional, stated the hospital, which has started bi-directional screening of TB-COVID and TB-ILI/SARI.

Dr Parinita Kaur, senior consultant, Internal Medicine, Aakash Healthcare, said that these tests are being done at OPDs and COVID wing to make sure that TB screening is done for all patients who have persistent cough, fever, cavitation lesions, new lung infiltrates, abdominal symptoms, or decline in general condition.

Source: The New Indian Express